Urinary Frequency and PANDAS
On the evening I read this pearl (timing is everything!) I had just that day
seen a new patient: twelve year old girl, Tanner II, who was in with chief
complaint of urgency and frequency: no dysuria, no fever, no belly or back pain,
no incontinence day or night. No history of previous UTI. Not feeling or
acting sick, but in the bathroom to void literally every half hour or so daytime,
with by her own history, very small amounts voided.
The mother said her behavior was pretty remarkable for the past 36 hours, she
was always in the bathroom (with a rolling of mother's eyes and a shaking of
her head out of the child's view that suggested that this was something and
new for the child ...)
Her exam that day was unremarkable, no evidence or current history of sore
throat, no one else in family was sick. No repetitive or otherwise unusual
movements that day on exam or by history. Urinalysis that day was negative.
Culture came back today, also negative.
I called mom this afternoon to ask how she was doing and let her know culture
results. It seems that the voiding has improved somewhat, but now she has a
very sore throat, mother has inspected and it looks "terrible."
Kicking myself, but no throat culture done that day. Today we had snow and
freezing rain, and mother who works at home, was not going out for medicine,
let alone swinging by for a throat culture. Now the other two kids in the
family sick also with sore throats.
Should be interesting to follow her, her story is a first for me, and a
timely Medscape article, all things considered.